A functional near-infrared spectroscopy study on hemodynamic changes of patients with prolonged disorders of consciousness responding to different auditory stimuli

Abstract

Treating prolonged disorders of consciousness (pDoC) is challenging. Thus, accurate assessment of residual consciousness in patients with pDoC is important for the management and recovery of patients. Functional near-infrared spectroscopy (fNIRS) can reflect brain activity through oxygenated cortical hemoglobin/deoxygenated hemoglobin (HbO/HbR) changes and has recently gained increasing attention for its potential applications in assessing residual consciousness. However, the number of fNIRS studies assessing residual awareness in patients with pDoC is still limited. The following study evaluates the brain function in 18 patients with pDoC (including 14 vegetative states [VS]) and 4 minimally conscious states [MCS]) and 15 healthy controls using two types of external stimuli, i.e., active stimulation (motor imagery) and passive stimulation (subject's own name [SON]) by fNIRS. The results showed that the mean concentrations of HbO/HbR in the prefrontal cortex of the healthy controls during the passive stimulation were significantly lower than those of the active stimulation, and the slope of the best-fit line was high. However, the hemodynamic responses of the patients with pDoC were opposite to the healthy controls. Additionally, the mean concentrations of HbO/HbR increased as the level of consciousness decreased during passive stimulation. Our findings suggest that the residual level of consciousness in pDoC patients can be assessed by measuring brain responses to different stimulations using fNIRS. The present study further demonstrates the feasibility andreliability of fNIRS in assessing residual consciousness in patients with pDoC, providing a basis for its expanded clinical application.